What is Glaucoma?
“Glaucoma” in simple terms is called as “eye pressure”, which is caused by insufficient drainage of fluid called aqueous humour within the eye, whose primary function was to maintain pressure within the eye and also to supply required nutrition to the lens and the cornea. This accumulation of fluid (aqueous humour) within the eye, leads to raised eye pressure (intra-ocular pressure), which in turn has a tamponade effect on the optic nerve, leading to development of glaucoma. This irreversible damage to optic nerve leads to peripheral constriction of his/her field of vision, which eventually leads to tubular vision and vision loss.
What are the Symptoms of Glaucoma?
99% of primary chronic form of glaucoma patients are asymptomatic! Patients with glaucoma usually presents with symptoms only at advanced stages of glaucoma and they present with disturbances in peripheral field of vision, defective vision, frequent change of glasses etc. Few percentage of patients may present with acute form of glaucoma include pain, redness, coloured halos, smoky vision, headache and vomiting, which one form of emergency in eye care. A routine yearly eye check-up of patients above the age of 40 or with family history of glaucoma is usually advisable to rule out glaucoma.
What are the Types of Glaucoma?
Glaucoma can be Primary(idiopathic) or Secondary (with a cause like trauma, steroid usage or due to inflammation) or Congenital. When drainage pathway (angle of anterior chamber) is open but drainage is restricted, then it’s called “Open Angle” variety! If the drainage itself is blocked, then its “Angle Closure” variety!
Procedures & Services
Glaucoma is diagnosed by regular comprehensive eye check-up at our Eye Trust Hospital. Initial glaucoma workup involves the measurement of the intraocular pressure (IOP) with the help of a Goldmann’s Applanation tonometer, evaluation of the angle of the eye with a Goldmann goniolens, examination of the optic nerve head by slit lamp bio-microscopy and the measurement of the central corneal thickness using a pachymeter. Ultrasound bio-microscopy helps us to further assess angle details and dimensions and actively intervene based on the findings.
Visual field is used to assess subjectively patient’s peripheral field of vision and we use “Octopus” visual field analyser at our hospital. This visual field analyser is fast and very reliable at very short time with less fatigue.
Optical Coherence Tomography (OCT) from Nidek spectral domain technology, is latest in glaucoma diagnostics, that gives us a quantitative objective form of measurement of the retinal nerve fibre layer, primary layer damaged in glaucoma.
Stereoscopic photographs of the disc taken with same Nidek Spectral domain OCT, helps us to identify visible structural damage of Retinal Nerve Fibre Layer(RNFL) and also helps as to appreciate visible progression of damage of RNFL fibres in serial photography’s.
Can it be Treated?
Aim of treatment of glaucoma is primarily to prevent further progression of glaucoma and to preserve existing vision and nerve. Most of the patients are managed with medications only. Angle closure patients are treated with laser (laser iridotomy) initially to open up the blocked channels and managed medically. Glaucoma patients, whose eye pressures are not controlled despite maximum medical therapy needs “Surgical treatment” in the form of Trabeculectomy.
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